title: Maxillary sinus recovery and nasal ventilation after Le Fort I osteotomy: a prospective clinical, endoscopic, functional and radiographic evaluation.
abstract: The condition of the maxillary sinus is not routinely assessed before a Le Fort I osteotomy. Performing this procedure in an infected sinus might account for a considerable proportion of the complications, such as excessive bleeding and sinusitis. The aim of this study was to evaluate the maxillary sinus and nasal ventilation after Le Fort I osteotomy. Twenty patients were evaluated before and 2 months after surgery using validated questionnaires for sinonasal complaints (RSOM-31 and VAS score), nasal endoscopy, peak nasal inspiratory flow (PNIF), and a computed tomography (CT) scan. There were no differences in complaints before and 2 months after surgery (P>0.24). Also, the PNIF did not change significantly (P=0.10). On CT evaluation before surgery, a previously unnoted sinusitis was diagnosed in two patients. Postoperatively, a thickened sinus mucosa was present in all patients near the osteotomy line, the osteosyntheses, and around sequesters. This report describes maxillary sinus evaluation after Le Fort I osteotomy in a more comprehensive way by using CT. The Le Fort I procedure did not influence already existing physical or mental complaints, and nasal ventilation was not negatively affected. However, evaluation of sinonasal pathology should be emphasized in the preoperative work-up.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Isala Clinics, Zwolle, The Netherlands; Department of Oral and Maxillofacial Surgery Academic Medical Centre and Academic Centre for Dentistry, Amsterdam, The Netherlands. Electronic address: m.h.valstar@amc.uva.nl.
authors.forename: M H
authors.initials: MH
authors.lastname: Valstar
authors.forename: E M
authors.initials: EM
authors.lastname: Baas
authors.forename: J P
authors.initials: JP
authors.lastname: Te Rijdt
authors.forename: B J
authors.initials: BJ
authors.lastname: De Bondt
authors.forename: E
authors.initials: E
authors.lastname: Laurens
authors.forename: J
authors.initials: J
authors.lastname: De Lange
mesh_terms: D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D009666:Nose / Q000473:pathology*; D019340:Osteotomy, Le Fort; D010865:Pilot Projects; D011183:Postoperative Complications; D011446:Prospective Studies; D012852:Sinusitis / Q000175:diagnosis / Q000209:etiology*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
keywords: CT; Le Fort I; osteotomy; sinus; sinusitis; ventilation